Read on for the inside scoop about the people and events behind the scenes at Fauquier Health System - Hospital in Northern Virginia.

Tuesday, March 10, 2009

Sleep Apnea Surgery Gives Patient a Wake Up Call

Click on the video above for a quick introduction to Dr. Christopher Chang of Fauquier ENT.

A 48-year-old Rappahannock man who was diagnosed with obstructive sleep apnea three years ago is finally cured. He said, “The physical improvement is great. To sleep well, to know what it is to dream, to have energy throughout the day, and to know that when I wake up in the morning that my body hasn’t been struggling for breath all night. I thank God for this change in my life.”

As an unexpected bonus, his life insurance premiums have dropped significantly and his severe snoring has completely disappeared.

Obstructive sleep apnea (OSA) is a serious medical condition where the throat and nasal tissues collapse when the patient is asleep, and air movement is obstructed. OSA not only prevents sufferers from having a good night's rest, but it also increases the risk of heart attack, stroke, hypertension and even death. Symptoms include:

• Severe snoring• Feeling tired during the daytime• Morning headaches• Restless sleep• Waking up repeatedly throughout the night• Loved ones reporting that the patient literally stops breathing repeatedly throughout the night• Sore throat in the mornings

Respiratory therapy is the first line of defense in cases of diagnosed OSA, but it is not the only solution. Dr. Christopher Chang of Fauquier Ear, Nose and Throat Consultants said that there are several surgeries that can alleviate – and possibly cure – OSA and its symptoms.

He explained, “If someone is diagnosed with obstructive sleep apnea through a sleep study, insurance companies require the patient to try CPAP (Continuous Positive Airway Pressure) therapy first. If after trying it for several months, the patient can’t tolerate the therapy or it doesn’t work, surgery may be covered.

Dr. Chang estimates that in selected patients, his success rate with OSA surgeries is “more than 90 percent. These patients see significant improvement or are even cured completely.”

He explained, “The three clogs contributing to OSA include nasal factors, oral cavity factors and tongue collapse against the back of the throat. Individuals may have one or all three contributing to the OSA. The best analogy to use is a pipe through which water flows. Imagine this pipe has three clogs in it. Water flow will not improve until all three clogs are removed.”

One of Dr. Chang’s patients, the Rappahannock man mentioned above, was battling all three points of resistance to air flow. He said that after a sleep study at the Fauquier Health Sleep Center in Warrenton, he was diagnosed with OSA. He tried CPAP therapy for three years but it didn’t alleviate his symptoms.

In October of 2008, Dr. Chang performed an uvulopalatopharyngoplasty (UPPP) where the uvula is removed, soft palate is trimmed to clear the oral cavity, and tonsillectomy is performed in order to open up the oral cavity. Also performed was a base of tongue reduction to address the tongue collapse against the back of the throat. In January of 2009, the patient had a second surgery to correct a deviated septum, as well as turbinate reduction to reduce the size of his nasal turbinates (to clear the nasal blockage).

After another sleep study last month, the patient was declared “completely cured of OSA.”“I feel great. And now my wife can get a good night’s sleep, too,” he added.

Dr. Chang said that there also are other procedures that can be performed to free the flow of air while sleeping. In the interest of educating his patients as much as possible, Dr. Chang has an extensive website at www.FauquierENT.net with descriptions – including videos -- of the different symptoms and possible solutions.